' ON SUBCUTANEOUS SURGERY. 11 



brought into contact with organic fluids of vegetable and 

 animal origin, have carried the conviction of the truth of the 

 germ-theory to many minds ; and the practical application of 

 it to surgical practice is undoubtedly spreading in the profes- 

 sion, through the untiring zeal and enthusiasm with which 

 Professor Lister endeavors to instruct the profession in all 

 the details and minutiae which he has found to be necessary 

 to the successful application of his method, both in operating 

 and in the dressing of wounds. 



Then with regard to the third question, which relates to 

 the conditions necessary to the irritating influence of the air, 

 it must be admitted that the mere contact of the air with 

 divided surfaces, but without an external wound, is not 

 sufficient to produce inflammation, or, at least, that it seldom 

 does so. Of this we see evidence in ordinary cases of emphy- 

 sema connected with fractured ribs, in which, as a rule, no 

 Inflammation of the cellular tissue follows, though the emphy- 

 sema may be very extensive. 



Abundant evidence of the same fact was supplied by Mal- 

 gaigne, in the important discussion on the " Subcutaneous 

 Method," as M. Guerin called it, which took place in the 

 " Acad^mie de Medecine" of Paris in the year 1857. M. 

 Malgaigne brought forward a series of experiments on animals, 

 first rendered emphysematous, and then su.bjected to various 

 subcutaneous operations, so that the air was in contact with 

 the cut surfaces, fractured bones etc. ; no inflammation fol- 

 lowed. 



The explanation which the advocates of the germ-theory 

 would probably give, would be that in emphysema, the ex- 

 travasated air in contact with fractured bone or cut surfaces 

 has undergone a process of filtration, and that the filtered 

 air deprived of its germs is harmless. 



M. Malgaigne came forward as the opponent of the extended 



